Laserfiche WebLink
°44u1" APPLICATION - DEVIATION <br /> SAN JOAQUIN COUNTY COMMUNITY DEVELOPMENT DEPARTMENT <br /> \cq; FILE NUMBER: DV- <br /> SITE IMPROVEMENTS AND SERVICES <br /> Water <br /> Annex-Formation Distance to Public <br /> PublicWaterService Provider Required Water Feet <br /> Proposed❑ <br /> Existing❑ <br /> Private WaterM Existing Well'14 New Well ❑ Well Replacement ❑ <br /> Sewage Disposal <br /> Public Sewage Annex-Formation Distance to Public <br /> Disposal Service Provider Re uired Sewer Facilit <br /> Proposed❑ <br /> Existing❑ <br /> On-site Sewage <br /> Dis osal'm Existing Septic System New Septic System ❑ Other ❑ <br /> Storm Drainage <br /> Public Storm <br /> Drainage Service Provider(if Public) Annex-Formation Terminal Drainage Detention-Retention <br /> Proposed❑ Required to: Ponds <br /> Existing❑ <br /> Private Storm <br /> Drainage❑ On-site Retention Pond(s) ❑ Natural Drainage/No Change Other ❑ <br /> Electricity Telephone Service <br /> Distance to <br /> Service Provider Service Service Provider Distance to Service <br /> School Service Fire Protection Service <br /> Service Provider Distance to Elem Service Provider Distance to Fire Station <br /> School <br /> Existing Roads <br /> Road/Street Name R.O.W.Width Pavement Width Curb/Gutter Sidewalks <br /> 41, 7Z Yes❑ Nom 1 Yes❑ No 16 <br /> Yes❑ No❑ I Yes❑ No❑ <br /> FADEMMPlanning Application Foms0eviation.doc.(Revised 5-7109) Page 3 of 6 <br />